Gastroschisis

Case contributed by Dr Jeremy Jones

Presentation

Abdominal defect diagnosed antenatally.

Patient Data

Age: Day 1
Gender: Male
X-ray

Projected over the abdomen are loops of bowel. They appear external to the abdomen and you can see the external surface of the bowel loops (they are not covered by an external membrane).

X-ray

An ET tube is in the mid-trachea and there is right upper lobe collapse which is new compared to the previous study.

X-ray

The externalised bowel loops have been covered in a plastic wrap to stop them from dehydrating - don't be mistaken into thinking that this is a normal covering membrane.

Case Discussion

Features here are of gastroschisis - the differential is omphalocoele where there is a covering membrane. In patients with gastroshisis, a plastic covering is placed over the externalised bowel to stop them from drying out and becoming infected.

Of note is the interval right upper lobe collapse. While this may have been the result of tube movement, there was no such history. Bronchoscopy confirmed that there was an aberant right upper lobe bronchus from the distal trachea (pig bronchus) which had been obstructed by the ET tube which was in a position that would usually be deemed appropriate.

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Case information

rID: 27247
Case created: 25th Jan 2014
Last edited: 12th Mar 2016
Inclusion in quiz mode: Included

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